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Get 2004 Withholding Exemption Certificate

&TC Section 18662. This form cannot be used for exemption from wage withholding.) File this form with your withholding agent. (Please type or print) Vendor/Payee s name Vendor/Payee s SOS no. Vendor/Payee s address (number and street) APT no. 590 Withholding agent s name Social security number California corp. no. FEIN Private Mailbox no. Note: Failure to furnish your identification number will make this certificate void. Vendor/Payee s daytime telephone no. (.

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